Evaluation of Quality Indicators in Patients Receiving Intensive Care and Their Influence on Outcome Indicators and Economic Indicators

Retrospective Observational Study - Evaluation of Quality Indicators in Patients Receiving Intensive Care and Their Influence on Outcome Indicators and Economic Indicators

The aim of the study is to identify and evaluate incentive mechanisms for the implementation of quality-relevant care processes. The objective is to correlate adherence to individual process-based quality indicators or their combination with outcome data. In addition, cost shares and case revenues are evaluated. Indices are also derived from routine data that may represent additional influencing factors (Charlson Comorbidity Index or secondary diagnoses that increase case severity based on ICD-10 coding and procedures based on the Surgery and procedure codes system).

Within the Department of Anesthesiology and Intensive Care Medicine CCM/CVK at Charité- University Medicine Berlin, the systematic evaluation of quality-related process indicators is standard practice. These are based on the intensive care quality indicators of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI). These process-based indicators are to be correlated with the examination of outcome indicators from routine data transmission in accordance with §21 data record (e.g., 30-day readmission rate, mortality, infection rate, length of stay) and economic parameters of treatment from controlling data (Diagnosis Related Groups revenue, case costs). The §21 data record describes a standardized data format that hospitals are required to transmit to the Institute for the Hospital Remuneration System (InEK) in accordance with § 21 (4) and (5) Act on Fees for Full and Partial Inpatient Hospital Services (Hospital Fees Act - KHEntgG). Data on standard clinical care from the Charité hospital systems will be used.

Inclusion Criteria:

• Patients with complete, electronically documented intensive care treatment data, including vital sign monitor data and laboratory data from the patient documentation system.
• Complete, electronically documented treatment data for these patients from the hospital information system.
• Data from cost and revenue accounting from the hospital information system, §21 routine data records.
• Age ≥ 18 years
• Length of stay > 24 hours
• Intensive care units from the Department of Anesthesiology and Intensive Care Medicie (CCM/CVK) of Charité - University Medicine Berlin: "M101I", 'MPACU', "WAN-S14I", "WAN-S8I", "WAN-PACU". Since the introduction of electronic patient records, some of these intensive care units have had different names (e.g., MAN-101i, MAN-103i, W1i).

Exclusion Criteria:

-none